29-01-2013, 10:14 AM
RECENT TRENDS IN MANAGEMENT OF RHEUMATOID ARTHRITIS
RECENT TRENDS.pptx (Size: 1.43 MB / Downloads: 30)
Goals of RA Management
Changing the course of disease progression (slowing or stopping the disease)
Briefly review of disease management.
Use of recent treatments for managing rheumatoid arthritis
INTRODUCTION TO RHEUMATOID ARTHRITIS
Rheumatoid Arthritis is a autoimmune disease.
Causes inflammation of joint and other organs of the body.
It is characterised by:
Inflamed synovial membrane.
Formation of pannus.
Damage cartilage and bone.
PATHOGENESIS
interaction of lymphocytes
production of interferon
production of cytokines
inflammatory cell infiltration
release of MMPS enzyme
bone and cartilage erosion
DIAGNOSIS
X-RAYS: Soft tissue swelling and loss of joint spare, erosions.
BLOOD TEST: Measurement of rheumatoid factor and anti citrullinated protein antibodies.
CAMERAS: First camera is searching for hot spots around joints
Second camera is used to make 3D – picture.
TARGETED THERAPY
Passive targeting: By creating carriers that can pass through leaky vasculature.
Active targeting : By ligand that is specific to receptors
Liposome surface can be modified to achieve selective delivery of the drug to target cells, in RA lipid bilayer fuse with cell membrane
Liposomes get degrade in the targeted cell to release drug.
PIPE LINE AGENTS
TOFACITINIB: Tofacitinib is the first oral medication that is similarly effective as biologic targeted therapies for the treatment of rheumatoid arthritis.
Tofacitinib is a JAK3 [Janus kinase - 3] inhibitor. The drugs work by interfering with enzymes that contribute to the inflammation process that causes joint pain
OTELIXIZUMAB: Otelixizumab will be as effective in reducing symptoms as the current “gold standard” & “anti – TNF therapy”.
otelixizumab an anti – CD3 monoclonal antibody.
otelixizumab could rival anti – TNF therapy.
VACCINATION
Manipulating antigen presenting cells called dendritic cells with SIRNA.
SIRNA is a nucleotide long dSRNA molecules interfere with expression of specific genes.
Dicer help in formation of RISC.
SIRNA complex cleaves RNA strand and binds short antisense strand .
MRNA DEGRADATION
No protein expression.
CONCLUSION
Although it is a common disease, available drug produces side effects.
To overcome side effects of drugs, targeted therapy is used.
Besides targeted therapy of drug, recent advance conventional medicines, alternative treatments and surgical procedures are providing potential approach for management of rheumatoid arthritis.